We aimed to determine the pooled prevalence of diabetic foot ulcers in Pakistan. MEDLINE (PubMed), Web of Science, Google scholars, and local databases were systematically searched for studies published up to August 10, 2022, on the prevalence of foot ulcers among diabetic patients in Pakistan. Random-effects meta-analysis was used to generate summary estimates. Subgroup analysis and meta-regression models were used to address the issue of high heterogeneity. Two authors independently identified eligible articles, collected data, and performed a risk of bias analysis. Twelve studies were included in the meta-analysis (14201, range 230–2199, diabetic patients), of which 7 were of “high” quality. The pooled prevalence of diabetic foot ulcers was 12.16% (95% CI: 5.91–20.23%). We found significant between-study heterogeneity (I2 = 99.3%; p < 0.001) but no statistical evidence of publication bias (p = 0.8544). Subgroup meta-analysis found significant differences in foot ulcer prevalence by publication year and by the duration of diabetes. An increasing trend was observed during the last two decades, with the prevalence of diabetic foot ulcers being the highest in the latest period from 2011 to 2022 (19.54%) than in the early 2000 s (4.55%). This study suggests that the prevalence of diabetic foot ulcers in Pakistan is relatively high, with significant variation between provinces. Further study is required to identify ways for early detection, prevention, and treatment in the population.

IntroductionBy conducting a systematic review and meta-analysis, we investigated the prevalence of neuropsychiatric (NP) symptoms among systemic lupus erythematosus (SLE) patients in Pakistan.MethodsIn this review work, three electronic databases (Web of Science, MEDLINE, and Google Scholar) and local databases were screened for 20 years from 1 January 2002 to 30 September 2022, to identify the articles evaluating the prevalence of NP symptoms in SLE patients in Pakistan. We performed a random-effects meta-analysis to estimate the prevalence of NPSLE. Statistical heterogeneity was measured by the I2 index, and subgroup meta-analyses were used to access the statistical heterogeneity. Furthermore, meta-regression models were used to examine the associations between prevalence estimates and study characteristics of interest. Three independent authors reviewed existing studies, extracted data, and rated the qualities of selected studies. This review was registered on PROSPERO (Registration no. CRD42022361798).ResultsThirteen studies met the inclusion criteria out of the 322 studies with a total of 2,003 SLE patients for this systematic review and meta-analysis. The prevalence of NP disorders in SLE patients was estimated to be 30.42% (95% CI:18.26–44.11%), with cognitive dysfunction being the most common (31.51%; 95% CI:1.28–76.27%), followed by headache (10.22%; 95% CI: 0.00–33.43%), seizures (5.96%; 95% CI: 3.80–8.53%), psychosis (3.64%; 95% CI: 2.38–5.13%), and neuropathy is the least common (0.86%; 95% CI: 0.00–2.74%). The heterogeneity between studies was significant (p < 0.01). The pooled prevalence of NP disorders among SLE patients was found highest in Punjab (41.21%) and lowest in Sindh (17.60%).ConclusionFindings from this study revealed that SLE patients have a high prevalence of NP disorders. The most common symptoms were cognitive dysfunctions, headaches, seizures, psychosis, and neuropathy. Clinicians can manage these potentially deadly and disabling diseases more effectively if they understand the incidence of each NP symptom in SLE patients. NP symptoms among SLE patients are at their peak in Pakistan; policymakers should devise preventive strategies to curb the disease.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record. php?RecordID=361798, identifier CRD42022361798.

Background: All the patterns of mortality and encumbrance of diseases in a residential area can be observed from the patients admitted to a hospital. Mortality is the oldest well-known healthcare indicator and an important instrument for planning and well organizes management purposes in hospitals. This study was carried out to evaluate the cause-specific mortality patterns among hospital deaths in Mardan district, Pakistan Methods: The study was conducted between April 2018 to April 2019 in admitted patients in District Headquarter Mardan. 200 samples of deaths were collected through a questionnaire. The questionnaire consists of the information age, sex, residence, and causes of death. SPSS 21 version was used for statistical analysis. Study area map was design through ArcGIS version 10.8. Results:As per our results 138 (69%) were males and 62 (31%) were females. Maximum deaths occurred based on age 46-60 years (25.50%) followed by 31-45 years (24.50%), 61-75 years (20%), 16-30 years (17.50%), 1-15 years (5.50%), 76-90 and 91-105 years combine (3.50%) respectively. The deaths in rural areas 129 (64%) and urban areas were 71 (35.5%). The leading cause of mortality was RTA (13.50%), followed by femoroacetabular impingement (13%), chest pain and dextromethorphan (DM) (8%), poisons case (7.5%), hypertension and heart failure (6.50%), cerebrovascular accident (CVA) (5.50%), shortness of breath (SOB), renal failure and chronic liver disease (CLD) (4.50%), head injury and stroke (3.50%), hepatitis C virus (HCV) (2%) and other diseases (9%) respectively. Conclusion:The majority of deaths occur in the age of 46-60 in Mardan hospital. The proportion of deaths was large in males than females. Residence-wise mortality in rural areas was large than in urban areas. The leading cause of mortality is road traffic accidents (RTA). It is suggested, the policymaker should devise strategies to minimize accidents. It is further suggested that to make health care centres in rural areas and to depute trained medical staff.